Nov. 22, 2021

"#16 - The Creatively Engaging - Terry"

"#16 - The Creatively Engaging - Terry"

Join us for a great conversation with CEO of BC Care Providers, Terry Lake.


"The Creatively Engaging" website...

https://www.thecreativelyengaging.com

British Columbia Care Providers Association

https://bccare.ca

The Imagination Network

https://imaginationnetwork.org

"Raising the Curtain" Project

https://imaginationnetwork.org/raising-the-curtain/

"Raising the Curtain" Co-Lead Organization - Deer Crossing the Art Farm

https://deercrossingtheartfarm.org

"Raising the Curtain" Co-Lead Organization - Douglas College Therapeutic Recreation Program

https://www.douglascollege.ca/programs-courses/explore-programs-courses/faculties/applied-community-studies/therapeutic-recreation

Transcript

Bruce Devereux:

My guest today is Terry Lake, a former Canadian politician at both municipal and provincial levels. A veterinarian, and currently the CEO of BC Care Providers. I'm not going to spend a great deal of time on the intro today because I want to jump right into the conversation, where you'll hear in detail more about Terry's background, his accomplishments and future endeavours. 

Welcome to The Creatively Engaging Podcast with my guest Terry Lake. Okay. So this is our second attempt at the interview and the first attempt, I think it was an atmospheric river that shut down the internet on our side. And we've been through a bomb cyclone, two atmospheric rivers, a tornado, mudslide, floods, and evacuation.

 

Terry Lake:

Yeah, it's been absolutely crazy here of course the summer was wildfires all around us. And now we're cut off from the lower main line completely. It's been a crazy year.

 

Bruce Devereux:

I know.

 

Terry Lake:

All in the middle of COVID of course.

 

Bruce Devereux:

Yes, exactly. Adds a whole other layer to it. Right?

 

Terry Lake:

Mh-mm-hmm (affirmative).

 

Bruce Devereux:

And it was interesting when I was talking, getting ready for the interview at my care centre. So I had them try and guess who the guest was. I said the guest was a former city counsellor, a former BC Transit board member, a veterinarian, an animal health tech instructor. The former mayor of Kamloops, a broadcaster, which I didn't know, vice president and treasurer for the World Small Animal Association. He lobbied to ban the use of exotic animals for entertainment, was head of the Sled Dog Task Force following the Whistler sled dog call incident. He was the minister of the environment for BC, he was the minister of health for BC. And he is currently the CEO of BC Care Providers. And it was pretty funny because one of the residents she's just looking at me, she has quite a sense of humour and she goes, "Do you think after you're done, you could get Superman's autograph for me?”

 

Terry Lake:

I think it's just being old. You get to do a lot of things if you live long enough.

 

Bruce Devereux:

I don't know. Well she was in her '90s, right? So-

 

Terry Lake:

Oh, that's funny.

 

Bruce Devereux:

... she was pretty impressed, pretty impressed. But after the Superman comment, she said, "What is BC Care Providers?" So maybe I think that's a good lead in for us and people that are listening.

 

Terry Lake:

Sure. BC Care Providers is the industry association that represents contracted providers of care. So these are either not for profit organizations or in some cases for profit organizations that provide services through health authorities for assisted living and long-term care. But we also have an operating arm called EngAge BC which represents providers of independent living. So retirement living that are not supported by government and also private home health providers as well. So really the whole seniors care and living spectrum is represented with the largest of our industry associations here in British Columbia. When I was health minister I worked very closely with this organization because obviously they provide about two thirds of the long-term care and assisted living spaces in the province of British Columbia.

 

Bruce Devereux:

When did BC Care Providers start?

 

Terry Lake:

Well, it started originally about 40 years ago as PRICare, which was short for Private Care. It was a different system back then, of course. There wasn't as much government support for assisted living and long-term care services today. And so was a lot of private care and eventually with the evolution of more and more government support of the need, obviously for long-term care, it transitioned over. So I think in this form it's been probably the last 20 or so years. It's been the BC Care Providers Association and has some many, many preeminent chairs of the board. Aly Devji is the current chair he's transitioning out of that position this year. But Karen Biggs from Menno Place, one of the largest long-term care assisted living communities in British Columbia.

 

Terry Lake:

A lot of these folks have been in the senior care sector for decades. And in fact, in Aly's case, which is not unusual, it was a family run operation. So his mom and dad started or bought a small care home 35 years ago. And so he's lived all of his life in the care sector. So it's really a neat group of people that care deeply about seniors care. And they're also very entrepreneurial as well. And very much, think you can combine very good service for seniors and also create a good business opportunity as well.

 

Bruce Devereux:

So when I look at the BC Care Providers, the organization, how many organizations, these would be within your umbrella?

 

 

 

Terry Lake:

We have about 400 members. Those who would include individual sites of some organizations that have more than one site. We have some members that are just private home health providers, we have some that have the full sort of gamut of care from retirement living, assisted living and long-term care. Quite a number of, I think over 400 members. And those would include some commercial members too that provide equipment and services to the seniors care sector.

 

Bruce Devereux:

Well, quite a large scope, a spectrum people involved in the organization.

 

Terry Lake:

Yeah. Anyone that's been to our conference, our annual conference, which we're having again in-person again finally in Whistler early part of June of 2022, anyone who's gone to that conference can see the spectrum of members from commercial to multi location, to the small non-profits. It's a very good collection of our membership and great learning opportunities and great social activities as well.

 

Bruce Devereux:

And I heard you emphasize in-person.

 

Terry Lake:

Mm-hmm (affirmative). Yeah, we've run our last two conferences online as many organizations have and they've been very well received. And of course there are some benefits to being online. It's more accessible for people. They don't have to travel, it's cheaper. They can in many cases go back and watch recorded sessions at their own leisure. But there's really nothing that can substitute for being together in person, the hallway conversations, the dinner conversations, the exhibitors of course prefer the in-person events because people can get that touch and feel and an intimate conversation with the vendors. So we're really looking forward to that. And after last couple of years of COVID, I think people just need to come together and celebrate what they've been able to manage in such challenging times. I think there'll be a real catharsis that occurs at that conference in June.

 

Bruce Devereux:

Yeah. Because the theme of it just jumping into it is up, up and away and the theme just focus on a positive vision for seniors living and continuing care sector.

 

Terry Lake:

Absolutely. Yeah.

 

Bruce Devereux:

So we're definitely not going back to the way things were.

 

Terry Lake:

No, I think the crisis of COVID has laid bare some of the weaknesses of seniors care in Canada and around the world to be honest. But our response, I think has shown that people who work in this sector are very passionate about what they do. Very committed to the people whom they serve and very innovative and creative when it comes to dealing with these challenges. But what we do know is that people living in care and even in retirement, living in cases were separated from their families and friends in the later part of their life, which was tragic in many ways. And I think what we've learned is that quality of life is as important as quality of life. And what we can't allow to happen is going to a hospital based model where we're so afraid of germs that we don't allow this to be people's homes and have that quality of life that's so critical.

 

Bruce Devereux:

People spend a lifetime investing in their communities. And they don't necessarily want to live in a healthcare facility. They probably don't want to live in, what's recognized as a continuum of care. And the next generation of individuals say myself, for example, that will be searching for a suitable supportive living will be the first to have really experienced finding a place for our parents to go into. I know for myself that would be an experience that will shape the type of place I want to live in. How do you feel the care sector can steer the next generation of individuals away from the idea of supportive living as being something they're forced into and toward an experience that they're actually drawn to?

 

Terry Lake:

That's such a good question, Bruce. And I think it's the challenge for us as a sector. I don't think there's one answer because is what I've learned through my dad's journey, my dad just recently passed away. He was frail, he was in need of care. And so we did like many people of our age do we'd look for the best possible environment for our parents to support them, to give them a quality of life, but also, that takes into account the needs of their caregivers, because it is tremendously difficult on spouses, on siblings, sons and daughters and their families trying to find the best situation for their parents. So I think we have to really individualize things and say, "Okay, what sort of environment does this particular person need based on not just their physical health and their mental health, but also the type of person they are?”

 

Terry Lake:

My dad was a very social person and nothing he loved more than going to senior centre and playing cards and conversing with people. And he could not do very much of that during COVID. His quality of life was getting worse, worse. He lived at home in apartment with his second wife who also was encountering health difficulties. And he lived in Kelowna. So Interior Health provided home health services, but my dad was very reluctant to have people come into his home. So we started looking at assisted living and he wanted nothing to do with that at the beginning. And the two of them would essentially go into assisted living. And I convinced him with time that he should consider that, the social part of being in the dining room and having opportunities to interact with others and play games and cards and things like that.

 

Terry Lake:

He actually started looking forward to that. And then his frailty changed to the point where his doctor and his caregivers did not think that was the best thing for him, that he really should go on a palliative home care plan to increase his quality of life. And in many cases in palliative care, you actually live longer because you get more appropriate care. And so that's what happens. So people's needs change. And so it's hard for families and individuals to know what is the best environment. But I will say that we have the sort of ageism that occurs and people think about retirement living, no one wants to be in that kind of environment. But what I see, what I know older people that I have been associated with through politics, for instance, that are now in retirement living, they love having that independent living, but the congregate living situation where they can go and see their friends in the dining room, they can have visitors come in, they can have social activities, they can have organized events.

 

Terry Lake:

So I think sometimes society looks down upon retirement living as something that you're giving up real life to go into retirement living. Whereas for many people, it enhances their life because they're reconnected socially and we are so social animals, particularly someone that's lost a spouse to go into congregate living will just rejuvenate them in many ways. And so I think we need to have more discussions in society in general, and particularly among baby boomers like us that are thinking about what's next for us that this isn't a step down. This is actually just a different part of your life and you have different needs. And you need to think about what your needs and desires are and find out a way to meet them.

 

Terry Lake:

Now, when you get into physical or mental health deterioration, then that's different. And we know that 60% end of people in long-term care have either moderate or significant cognitive decline, then it becomes a different conversation. And often it becomes just the safest environment for them to live. Again, a close friend of mine in Trail has had to put her spouse in care because about Alzheimer's early onset Alzheimer's, and that's a crushing, crushing feeling for her, but it is the very best situation. And she takes him out every day and they still have lots of activities together, but for her and for his safety, it became the necessary thing to do. So it isn't one conversation, Bruce, it's a lot of different conversations.

 

Bruce Devereux:

It's interesting too, what you were just speaking about you as a former minister of health, even having some challenges convincing your dad, that this could be a good environment or a good move for him. I had the same situation with my mother, working in aging care for 30 years, took every skill and listening ability that I had to eventually work with my mom to say, it'd be better. And once she made the move for her, it was really fantastic.

 

Terry Lake:

Absolutely.

 

Bruce Devereux:

People going into a care centre is having the opportunity for really, to be about contribution and purpose and being a difference maker. And one example that I read in the States that was quite interesting was where in an assisted living facility, the residents were actually helping some of the staff get their citizenship. And I thought what an amazing opportunity for the individuals that live there, but also for the staff that are there to see that kind of connection and that relationship that would be built would be amazing.

 

Terry Lake:

Yeah, I think you're so right. I mean, that purpose is so important to us as humans in that environment. I think that's a great example, we have a lot of people who work in long-term care that come from many communities, they're new immigrants. They're trying to upgrade their skills, their citizenship status. And there's lots of expertise in people who are in assisted living or retirement living, or even in care that can provide that assistance and support. It is something that is really important to provide that sense of purpose for people. Now, of course, again, that depends on, ability to have the cognitive health. And so again, it's different things for different people, but somehow we have to connect seniors at all levels of living in care with something that is familiar, that gives them purpose. We have to understand what we need as humans and try to find ways and means of providing that whether it's art, music, pet therapy or are giving people purpose in helping others.

 

Bruce Devereux:

And building that community.

 

Terry Lake:

Absolutely.

 

Bruce Devereux:

One of the big changes that we witnessed and quick adoption was in the whole Telecare and Telehealth. What are some of the positives and negatives that you have seen in this rapid adoption of Telecare and Telehealth movement?

 

Terry Lake:

Yeah. I think in the general public and as a former health minister, I see this as a great benefit is being able to connect with your healthcare providers quickly without having to get in your car or wait in a waiting room. And I've seen my doctor by telephone twice in this past year. And to me, it was every bit as good as the usual visit in person visits I have. And for people in care, I think being able to have those virtual visits is helpful for the care staff and the resident. You do have to lament the in ability to see someone because body language is important and touch is important. So I think that there's a combination of things there that we need to have that balance of in-person versus virtual, but I absolutely believe, and I believe does health minister that we can do far more with connectivity to maintain people's health and make them and their families, partners true partners in their healthcare.

 

Terry Lake:

There's a system that Nova Scotia adopted whereby you can create this circle of care virtually so that your pharmacist, your nurse, practitioner, your specialist all have access with you and your family to your health record. So everyone knows what's going on and people can put in information. And so there's a more of a comprehensive understanding of the care that that person has received and everyone is on the same page. So we need to get there where we're far, far behind, we still depend on the fax machine in healthcare, which is unbelievably shameful.

 

Bruce Devereux:

When COVID hit. It really caught a lot of organizations off guard with regards to their technical and technology infrastructures. Because I know for example, at our site, we just didn't have the Wi-Fi that was stable or strong enough to all of a sudden, I think we did close to 2,000 Zooms during the peak before visitation started to happen in person. And the Wi-Fi would be cutting out or spotty different areas. But because of that, it's been upgraded throughout our site and now it's super fast and it's great. It exposed the weakness, I think in that way. Right?

Terry Lake:

Yeah. And then the creativity, there's a company called Care to Talk that we work with Jordan Schley and his group, and they've created these tablets. But they put software on the tablet that makes it very easy for the resident. And we've distributed this to a number of homes and a pilot project. And in Ontario they're starting to use them as well. So I think they say that necessity is a mother of invention. And I think we've seen that in areas of communication, particularly as you mentioned Zoom meetings with families. So you can do your resident council meetings by Zoom, and you're going to get far more participation than if everyone has to come in to the same location at the same time.

 

Bruce Devereux:

So let's imagine a bit of a future where say, for example, the care sites are being built are they may be smaller. There's more of them, they're throughout the community. And then we have some of the larger older sites that are obviously been built 10, 15, 20 years ago. What are the possibilities that you could see how we could retrofit almost some of those sites?

 

Terry Lake:

You get a lot of heads nodding when people talk about that. You've got maybe 12 residents and a care staff that's very connected to those residents. But on the other side of that equation, you don't have the economies of scale that you do with a larger operation where you maybe have an HR team that is specialized, a supply chain team that's specialized, a kitchen that's specialized. And even when you think about care aids. Care aids, and nurses and other allied health professionals essentially do a very limited number of tasks. And in that smaller environment, you really do need someone that's more cross-trained because you won't be able to have a lower large staff, you have a small staff and they have to be able to do different things. So not only do we have to think about the physical infrastructure of these smaller homes, we have to think about the staffing model.

 

Terry Lake:

And that means working with unions and funding partners like the Province be able to enable those smaller homes. Now we have seen that if you take a larger home and subdivided into those smaller communities of care that you can combine some of the benefits of a smaller wing, if you like with the benefits of economies of scale, but you still have that staff model problem where you've got limited number of tasks because people's job descriptions are very discreet and they can't cross over and do something else. So I think we need to really put some thought into this and look at other places where they've made this work. But I also think that it's going to be a more expensive model. And so as taxpayers, we have to agree that we need to invest more in seniors care.

 

Terry Lake:

Dr. Samir Sinha often talks about the fact that we under invest in seniors care by about 30% versus our OECD peer countries. So if you look at Germany or France or the UK, Scandinavian countries, they invest more in seniors care than we do. That's a tough conversation because we know that healthcare is the most expensive part of government at the moment. And particularly end of life care is the most expensive part of healthcare, but we have to make a decision whether or not we to truly invest in quality of life for seniors whether it's in assisted living, home care or in long-term care.

 

 

 

Bruce Devereux:

So that makes me think of two things like I had mentioned in retrofitting. I think when I look at our site within the community of Gibsons, and one of the biggest is attracting staff because the cost of rental housing say, or just housing in general. But it's also having that space finding the spaces. And I'm thinking we have 60 assisted living suites, which are 600 square foot, one bedroom apartments, basically. So what if 10 or 12 of those were used for community rentals? So then you have say we have three floors, 20 on a floor, we have three families. Maybe we have a couple with a child or a single parent with a child that are now living within the, well, I'll call it a care centre. But all of a sudden the dynamic of that changes too, because if, imagine I was living at my centre and I'm out in the community and somebody asks me where I live, I would say, "I live at Christenson Village." And they say, "Oh, that's a care centre.”

 

Bruce Devereux:

I said, "Well, no, not necessarily. There are people that need care, but there's also other people living there." So a way I think that would break stigma also provide an opportunity for housing on the cost and maybe even looking at it for staffing. Because one of the big things you have is staff will come to our site, want to work there, but there's nowhere to live. There's nowhere even to transition, not going back to the days. Like I grew up in Cape Breton with the coal mining towns and company housing, but figuring out some type of solution of that retrofit of the building and how that changes the dynamic of what that space would be like.

 

Terry Lake:

Yeah. I agree. We've been talking a little bit about this and in fact, the government is talking about allowing staff to reside in homes on an emergency basis, as we get into critical staffing shortages through the pandemic. So there's a lot of ideas floating around about this. And we know in other jurisdictions, they have daycare centres connected to care homes and maybe a better term for a care home is a caring community, rather than care home. And so that would help de-stigmatize. I think other cultures are more reverent of their elders. We need to learn that kind of approach here in Canada, a little more. I think it will come, it will have to come because the baby boomers are going to be there.

 

Terry Lake:

There's such a huge number of us that as always baby boomers tend to drive a lot of policy changes. And so maybe that will be what pushes us over the line in many ways. But the cost of living, and it's not just confined to the lower mainland or the coast anymore, it's everywhere, even in your home province of Nova Scotia, the cost of homes as skyrocketed, as people have looked to move away from the more expensive parts of the country. So it's getting very difficult for people to find housing. And so I do think we need to be creative particularly to be able to combine staff in spaces available in the building would be ideal. I think when we look at the pandemic, it would've been very difficult to have members of the public living on the same site for infection prevention and control purposes.

 

Terry Lake:

But certainly staff that would make a lot of sense. In fact, it probably reduce the likelihood of the virus getting in because they're all in mostly the same built environment. So I think we do have to start thinking about those things. My concern is that governments are dealing with so many crises at the same time. We've got COVID 19, we've got the climate change crisis. We've got public safety crises that include opioid overdose deaths. And now, just the climate change weather events that are occurring, that cause such damage to infrastructure, that government is going to be focused on so many different things. It's going to be very hard to get the laser focus you need to make systemic change.

 

Terry Lake:

I'll give you example. When we went through the first part of the pandemic, remember that first wave and the terrible situation that was going on in Ottawa, in sorry, Ontario and Quebec, particularly in long-term care. The federal government was really laser focused on this. The speech from the throne talked about what they were going to do. We saw the development of national standards, lots of money went towards long-term care. But when you look at this past federal election, when you look at press conference that have been held since then, seniors care is hardly ever mentioned. So we're dealing with so many different, important social, economic issues today that I fear that we won't have the bandwidth to deal adequately with seniors care.

 

 

Bruce Devereux:

Yes, those that other issues seem to once again, push seniors and aging issues to the side. So as you had mentioned a little bit earlier about cost, like smaller models cost more and financing and such, and we touched briefly before in another chat about, is it possible that a government could set up bonds or RSPs? So if I was to do a contribution, say yearly contribution, and I knew it was going towards aging care, is that even a possibility?

 

Terry Lake:

That's a good question. People today don't understand how seniors care is supported. They don't understand that 90% of long-term care that is, is publicly supported. So I mean, today you can buy long-term care. I mean, you can go to a private provider and that may be co-located with public supported beds, or may be standalone private provider, and you can spend $10,000 a month and get the level of care that you want, or your family wants food. It's very expensive. Or you go into public care and you get a very good level of care and you pay a co-payment based on your income level. But the thing is that, and I experienced this as a politician, as an MLA with people coming in to talk to me about their parents going into care.

 

Terry Lake:

It's based on your income. It's not based on your assets. And so there's this fairness discussion that makes this very complicated. If I'm someone that has saved, worked hard, bought a house, paid it off. But my income is relatively low when I need to go into care. I pay based on my income. So I'm go going to get a high level of public subsidy. People would argue, well, the family should sell your home to help pay for that care. But what about the person who didn't spent money differently, didn't save, didn't pay off a home and they don't have to then put their assets up for their care later. So it's really difficult. So if you have that bond, are you going to force everyone to put money into a bond? Or is it just for those who want to, and you shield it from taxes while it's up, it does create these two streams, again, which in Canada, of course, when we talk about healthcare, particularly we're very, very well activated.

 

Terry Lake:

You might say by the thought that someone is getting a different level of care based on their ability to pay. So it's a very complicated discussion. And I know there are models around the world, but in Canada, we have this mindset around healthcare that almost prevents us from having creative, innovative discussions about how we're going to pay for.

Bruce Devereux:

Because we just say, "No, this is the way it should be.”

 

 

 

Terry Lake:

This the way it should be. And we're the only country that has public health, a public Medicare system that doesn't have a parallel private pay track beside it. So even the United Kingdom, which set up the national health service in 1958, doesn't look like the 1958 model anymore. It has a private stream that functions well and is accepted by the public. But in Canada, we still have a system that looks like the 1958 national health service. And any discussion about changing it is political suicide.

 

Bruce Devereux:

How would you approach that?

 

Terry Lake:

As of a politician I would not approach it, but I think we simply can not have the discussion because when we talk about seniors care, it is that combination of publicly funded and a contribution from the recipient, which is a little different, but it is capped. You could be making a million dollars a year in your investment portfolio, but the most you would pay in public care is about $3,300 a month. And yet that service costs about seven or $8,000 a month. So again, I'm not sure how we have these conversations, except we can continue to educate people more and more about the system. Although I hesitate to call it a system, Bruce, because in my experience, healthcare is not a system. It's a series of things that are bolted onto each other. There's no real systemic plan. We, we make changes around the edges, but if we were to design the healthcare system today from scratch, it would not look like it does.

 

Terry Lake:

It's very inefficient. The outcomes are not what they should be, but we're entrenched. There's so much self-interest whether it's from unions, providers, physicians, you name it. There's so many entrance physicians that someone would object to almost any kind of change that you propose.

 

Bruce Devereux:

Yeah. It always seems that it is like a wheel and there's a layer of best practice gets applied at one point. And not really that transformation, it just goes around and here's another best practice and here's another best practice. And we just keep going on this wheel. And until we can reinvent the wheel, there'll be some real challenges there for sure.

 

Terry Lake:

Well, if you look at the funding model we have here in British Columbia for long-term care, basically the health authorities get a lock funding and they have to determine how to pay for long-term care and assisted living in their health authorities. So if you look at the one approach in Fraser Health, it would be different than the approach in Vancouver Coastal, or Island Health. So I mean, a senior needing care is the same, whether they're in Kamloops or in Victoria and yet the way it's funded and the way that the health authority owned and operated homes are funded is different. Even within a health authority, it's different. It's very confusing. It doesn't make a lot of sense. The government has committed to analyzing and reformulating the funding formula. But again, I fear that the resources and the bandwidth that they have is going to be diluted out by these other challenges. So it's going to be a while before we get around to it.

 

Bruce Devereux:

I know that BC Care Providers, you just had a big event, your Care to Chat on November 10th. Could you chat a little bit about that and some of the big takeaways that you feel?

 

Terry Lake:

Yeah. When I was hired a CEO 14 months ago, it was made clear that the biggest challenge in the seniors care sector and seniors living sector is the health human resources. How do we find the people we need to work and a big part of that, big part of that answer lies with internationally educated medical professionals, whether they're nurses or cares aids physicians. And so we are doing a lot of work with the the BC College of Nurses and Midwives, with the federal government, with the provincial government trying to find ways and means of unlocking the hundreds and hundreds of internationally educated nurses that are living here in British Columbia today that are not working in healthcare or not working up to their level of expertise. They have to go through a Byzantine system of credential recognition, competency assessment, language assessment, immigration processes.

 

Terry Lake:

So the Care to Chat brought together the College of Nurses and Midwives, the nurses and nurse practitioners of BC and an immigration lawyer from Toronto, who happens to be the chair of the board of not-for-profit long-term care centre, the Rekai Centers. And we talked about the efforts of the nursing college here in BC to streamline the process so that whether you think you are a licensed practical nurse, a psychiatric nurse, or a registered nurse, that you could apply one time instead of three different times, that you would get into one system that you would have your competency assessed, then you could get to work at the level of competency that's been assessed for you. So you might think, "I worked in the Philippines as a registered nurse," but the competency assessment shows that in Canada, you're working at the level or should be working at the level of a licensed practical nurse.

 

Terry Lake:

So let's get you going there. And then let’s identify the gaps and the mechanism to work you up to the level of registered nurse. And maybe that limited licensure. So you get to be accredited as a registered nurse, but maybe that's a registered nurse in seniors care. So you're not going to walk into the emergency room or operating room tomorrow as a registered nurse. You would be limited to obviously the more limited spectrum of tasks and duties and responsibilities that come with operating in one environment rather than operating in different nursing environments.

 

Terry Lake:

So that was our kickoff discussion about that. It's super complicated, again, so much self-interest because in other provinces, they have a college of licensed practical nurses, a college of registered nurses, a college of psychiatric nurses, and they don't want to give up their territories. Whereas here in BC, we brought all the colleges together so that they have one voice and are doing things in one way, makes it a lot easier.

 

 

Bruce Devereux:

Well, it sounds like such an inspiring way too, for the individual. They've been in RN say in the Philippines and they're here, and that tiered step up allows you to advance back to where you were within the system and step by step by step. It doesn't seem probably as overwhelming for the whole process and gaining that experience and filling the workforce too.

 

Terry Lake:

Absolutely. And you feel like you are doing what you were trained to do. You're working maybe even starting as a carry, but now with wage levelling, you're making $25 an hour. You're looking after people, which is what you want to do. And there are mechanisms put before you that allow you to work your way up to the next level. I mean, it sounds a bit utopian, but there's no reason that we can't do that. But again, it requires the post-secondary institutions, both public and private to be able to provide these pathways. It needs government to provide the funding necessary. It needs the regulators to come together and create that pathway.

 

Terry Lake:

We know in Ontario, the government there has offered up to $6,000 a year for internationally educated nurses to go through the process, because it can be very expensive to get your credentials recognized, to get your competency assessed or your English language training assessed. It's going to again, require an investment, but these are folks on the ground now that can help our critical nursing shortage that we have.

 

Bruce Devereux:

So as we draw a close, how do you see creating momentum to start building more inclusive of communities coming out of COVID?

 

Terry Lake:

Well, again, I think seniors care suffers from ageism, it's very prevalent in our society. And I know as someone who's now 64 that as you go through your life as a younger person and even into your middle ages, you tend to think that you're coming into your prime and that your later years you don't want to think about, or you don't think about positively. As baby boomers have this great big wave going into their '60s and '70s. I think we will have far more discussions about the kind of options we want available to us. And so that's going to, I hope displace some of that ageism. Although I think as humans, we are inherently that way because we feel mortality and it's just kind of natural in many ways.

 

Terry Lake:

But I think the more we have these discussions and the more we bring different segments of society together, as we talked about with daycares operating out of seniors homes or people living on site alongside seniors, giving seniors in care purpose, I think more of that will be created, but it has to be intentional as well.

 

Terry Lake:

So organizations like BC Care Providers and it's members have to come together and show that this is possible, that there are ways of making that happen. And we do know there's the Elim Villages and there are great examples that are out there. I just hope that investment is there to support them. Because what I fear is that as funding challenges become greater are greater, that will reduce the number of options that are available to people. I'll give you an example. Funding letters to operators, contracted providers of care, came out and there was a 1% inflationary increase for non-staff costs.

 

Terry Lake:

So that means all of your food other costs like insurance have to be covered with just a 1% increase. Well, we know that food has gone up at least 4%, we know insurance has gone up 15%. So I think we're going to have a real challenge. So creating that momentum is going to take a lot of conversations, a lot of pushing a lot, of families coming together and pushing the government in the right direction, talking to their MLAs, they're MP and writing letters and getting on social media and talking about how important it is to provide good quality of life for Canadians as they enter those years.

 

Bruce Devereux:

Terry, I'm so glad we had the chance to chat. The first time we did our tech check and then we got cut off in a storm, our internet in the last time. And then you've had a chance to have a bit of a break. And now we had our talk today, which was great. And I just want to say, thanks again, on behalf of my team and the Raising the Curtain and the Imagination Network, because it was back in 2017 that you presented the award for innovation of the year through BC Care Providers who provided the award. And that was brilliant because in the sense that you talk about contribution and purpose and value of what your organization is doing is we are four years out from that award. We're still going strong. We're actually building a national and an international audience and team and looking to build the community of practice in creative care.

 

Terry Lake:

Yeah. And congratulations, Bruce to you and your organization, it is innovators like you that are going to make a big difference. We can support that work of course, but it really takes people to push it and push it and push it and set an example for all the rest of us to follow. So thank you for doing that.

 

Bruce Devereux:

Thank you. A big, thank you to everyone for listening today. And I hope you enjoyed the episode as much as I enjoyed bringing it together. Thanks again to Terry and BC Care Provider staff, Marife, and Nico for helping to coordinate the interview logistics. You were fantastic. Thank you. If you like the episode with Terry, and feel it would be beneficial to others, please share. If you have the time to leave a quick comment on Apple Podcast, it really helps to build exposure and raise awareness of the change makers and the storytellers reshaping, how we view aging and creativity in our communities.

 

Bruce Devereux:

I feel very fortunate to have had the opportunity to speak with so many incredible individuals during the past 16 months. And I'm really looking forward to my next guests, Monika and Anna, incredible pianists, living in Vienna and London. Who'll be here to talk about their latest collaborative project, Piano Phase.